Project Setting

Our five-year study will be conducted in Northwest Cameroon, across nineteen districts. We selected Cameroon, because Cameroon has a high maternal mortality ratio of 600/100,000 births, and a perinatal mortality rate of ~50-60/1,000 births, among the highest worldwide. Also, Cameroon has expanding mobile phone coverage making it an ideal low-income country in which to evaluate m-MIST to improve pregnancy outcomes. Cameroon is classified by the World Health Organization (WHO) as having a critical shortage of healthcare personnel and equipment, exacerbated in rural areas (where most of the population reside), making it a high priority site to implement and test interventions that aim to improve maternity related outcomes.

Study Design

We will conduct a pragmatic stepped wedged cluster-randomized controlled trial to compare outcomes with and without m-MIST. The nineteen health districts in northwest Cameroon (65,000 total annual deliveries) will serve as clusters.

Potential Impact

If successful, this mHealth intervention will be a powerful tool enabling providers in low-income settings to deliver improved pregnancy care. Because the m-MIST intervention leverages existing infrastructure, is efficacious, the m-MIST intervention will be easily scalable to other regions in Cameroon and other low-income countries in Sub Saharan Africa, as well as to other health disciplines (e.g. internal medicine or surgery). We anticipate that implementation of m-MIST will lead to improved maternal and newborn outcomes and ultimately to improved population health and survival.

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